Technology has come a long way in the last 20 years since I
finished my residency in anesthesiology and critical care medicine at
Johns Hopkins University.

Back then, in the early 1990s, people actually read newspapers,
journals, and magazines on paper; it took more effort to put out
publications, and a great deal of effort was exerted by editors and
writers to effect a "scientific" balance for the reader. Even
when tackling political subjects, there was a professional pride and
ethos that imparted an implicit demand for honesty.

Today, we live in a world of cyber particles and LED screens,
pushing an overload of information that requires no more than the push
of a button to instantly send out information to literally millions of
potential recipients and readers. In the modern medium of publishing, it
is easy to cover a broad breadth of subjects, and even easier to be
prolific--something which can potentially be a very good thing in the
field of medicine. The 21st-century physician must be in command of the
latest breakthroughs, medical innovations, pharmaceuticals, and even
political machinations, all of which have profound implications for the
delivery of medical services and bedside care.

If you research the writings of the American Medical Association
over the last few years, since the topic of healthcare reform and health
insurance reform have resurfaced in the political arena, you will notice
a very marked bias in their writings. This is old news, right? Everyone
knows that today's AMA is a left-leaning organization, which
believes in "universal," socialized-type medicine at virtually
any cost.

We must remind ourselves, however, of how far the AMA has veered
from its historical path. There was a time when the AMA did not vote
pocketbook over principle, and did not promote the expansion of the
third-party system for payment of medical services. This is eloquently
shown in the Great Medicare Debate videos of 1962, featuring speeches in
Madison Square Garden by President John F. Kennedy (1) and Dr. Edward
Annis, (2) who later became president of the AMA, presented last year by
Dr. Alieta Eck, when she was president-elect of AAPS.

By 1983, the situation had changed. AMA entered a little known Pact
(3) with the precursor to the Centers for Medicare and Medicaid
Services, then known as HCFA (Health Care Financing Administration),
giving it the exclusive right to royalties from copyrighting the medical
billing codes used by all health insurance carriers in the United
States, the Current Procedural Terminology (CPT) codes. This was brought
to light through the original research and investigation done by AAPS
General Counsel Andrew Schlafly. (4) This monopoly on CPT codes brings
the AMA revenues of an estimated $70 million to $100 million annually.
Note that the AMA has a membership base of only about 15 percent of all
practicing American doctors at best; this membership has been declining
over the years, and these royalties to the AMA have precluded a need to
cater to the needs of the majority of physicians in independent
practice.

The AMA endorsed the so-called Patient Protection and Affordable
Care Act (PPACA), and despite widespread opposition among physicians,
AMA and state medical society publications show that the AMA federation
remains in promotion and implementation mode. (5-7)

What may be less obvious but no less interesting is the coverage of
healthcare reform by third-party journals and magazines, which cater to
those in the fields of nursing, medicine, outpatient surgery, and
biomedical products. These publications may have an obligation to stay
neutral in the debate, but no reader could possibly ignore the paramount
significance that reform attempts have on every aspect of the American
medical system. There is clearly an onus, even an imperative, to discuss
medical insurance reform, tort reform, interstate health insurance
competition, scope of practice barriers between physicians and
non-physicians, and so forth. Medical editors would have to consciously
work very hard to avoid including the healthcare reform debate in their
publications, but many have done just that by exercising perhaps the
most powerful journalistic tool at their disposal: silence.

Type "healthcare reform" into your search engine along
with the name of one of the many trade journals or medical newsletters
to test my premise. Many of the largest such periodicals have proven
themselves irrelevant, as demonstrated by the words "there is no
match for your search" coming on screen.

Others, like the American Academy of Neurology's newsletter,
have embraced the position that ideology simply does not matter. Bruce
Sigsbee, M.D., titled his President's column "AAN Advocacy
Focuses on Patients and the Profession, Not Ideologies." (8)
Apparently, it might be considered impolite to talk about how the
ideology of government-run medicine would negatively affect patients and
the profession. Pretending that ideology does not matter will not help
patients who will be victims of government-rationed care when
"universal coverage" does not equate with" universal
access."

Silence is a powerful weapon in our age of rapid communication;
many in positions of influence, such as medical editors and local
medical society directors, have evidently decided to ignore PPACA,
hoping that the Act will be quietly implement and transform society to
their liking. Rather than shed light on the most important
transformative process in the lives of any practicing physician (or
patient), they have focused their attention on lesser local, state, and
federal legislative issues. One is reminded of the metaphor of a
squirrel busily storing nuts under a tree that is shaking with every
movement of the hacksaw at its trunk. Even though the ground is shaking
and leaves are falling at a precipitous rate, the animal goes about its
daily business as if nothing new is happening at all. Dutiful observers
can see the bigger picture as the tree is felled and the landscape is
re-shaped around it, making any concern over lesser housekeeping chores
irrelevant. Are physicians being fooled by this charade?

Of late, it seems political leaders in and out of the field of
medicine are repeating the line" we need reform anyway "to
justify the shortcomings, under-estimated costs, and trampling of
liberties contained in the thousands of pages of PPACA. Censorship by
silence may be rationalized on these dubious grounds.

Even President Obama himself is loath to talk about his
"signature achievement," hoping that individuals affected
won't look at it too carefully or will simply forget about it until
it is fully implemented and it is too late to turn back. The president
has fully invested in silence--and generous waivers to those who might
not otherwise be silent, apparently in the hope that the referendum on
"ObamaCare" in the November 2010 mid-term elections won't
be repeated in the upcoming presidential election. (9)

PPACA has divided America. Regardless of the outcome of the legal
challenges destined for the Supreme Court, the contentious law designed
to gradually centralize and nationalize the way medical care is
delivered and paid for in America is sure to dominate the 2012 election
cycle.

Some may disagree on the legality of its application of the
Constitution's "Commerce Clause," but none can disagree
that PPACA seeks to dominate, control, and "manage" American
medicine from a more centralized, federal focal point and in a way
unprecedented in U.S. history. Recent rulings on PPACA by the federal
Eleventh Circuit Court in Atlanta and a federal District Court in
Pennsylvania found that the Act's individual mandate, demanding
that each American buy a health insurance contract from a
government-approved private company, is unconstitutional. This affords
some degree of comfort to those who still believe in the U.S.
Constitution as supreme law of the land. The Eleventh Circuit also
ruled, curiously, that despite the absence of a severability clause in
the law, the rest of the law could be implemented without the individual
mandate component. Could PPACA survive legislative funding cuts, or the
loss of premium revenue from those who buy insurance only because of the
mandate? The U.S. Supreme Court will decide the fate of the mandate. But
will the true enemy of the patient-physician relationship, regional
accountable care organizations (ACOs), live on regardless of a Supreme
Court decision or a change in the presidency?

After the rushed passage of the bill by Democrats only, after
secret meetings, leftist Democrats are worried about their political
survival. Medical society leaders and editors who supported it may also
be nervous. Those who crafted the bill, alleging that it was adequately
funded, apparently thought it could hobble through the next electoral
cycle before the consequences of full implementation could be seen.
Heightened attention about our national debt crisis may thwart their
intentions.

Regardless of their political persuasion, informed observers can
see the corrupt process by which this bill was enacted. The haste was
needed to accomplish the enormous power grab needed for the socialist
agenda. Republicans who took over control of the House of
Representatives in 2010 have made attempts to reduce the impact, but
corrupt forces are deeply entrenched.

Make no mistake about it: the elite minority who control the
medical establishment in America do so with unyielding focus on their
political agenda, no matter how out of step they are with practicing
physicians. What may seem like gentlemanly protocol to avoid contentious
debate is likely a dishonest effort to conceal this agenda, and allow it
to proceed without opposition.

The silence must be broken, and the truth about medical
organizations' collaboration in the government takeover of medicine
exposed.